HomeMy WebLinkAbout7733-zFOEM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Clerk's Office
Southold, N. Y.
Certificate Of Occupancy
No. Z723I+ Date Se.10t. .1~ 19.7.6.
THIS CERTIFIES that the building located at .. S. tillw, ater..Ave ......... Street
Map No..XX ......... Block No. XX ....... Lot No. XXX..O~tCh.og74e... ~.o.Y.., .........
conforms substantially to the Application for Building Permit heretofore fi]ed in this office
~ 2/28/?5 .8827Z...
dated ......... :: :8/30/-76,., 19 .... pursuant to which Building Permit No ?733g
3/3/75
dated .............. 9/.1./76.., 19 .... , was issued, and conforms to all of the require-
ments of the applicable provisions of the law. The occupancy for which this certificate is
issued is ....Pr.~.v.a. ~.e..q.n.e. fa..m~.]..y...d.~.e.~3...~, g.. ,~. t.h..a.d..d.i.~.~..o.n.~. .................
The certificate is issued to .l~lch.a.~.d. ~I.a.~l~.o.w. ak. $..~.~. ..... ~hclsez, ...................
(owner, lessee or tenant)
of the aforesaid building.
Suffolk County Department of Health Approval
UNDERWRITERS CERTIFICATE No. N,R,
HOUSE NUMBER ..... 3~[ 0. .....Street . ~;l~],~f~.~.e.~. A.v. fl ........................
FOI/~ NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 7733 Z
Permission is hereby granted to:
~cha~A..~[u=t~ow.~k:L.. ,L~. .............................
..... C~;~ .....................................................
~o .b..~-.~L .~.~.L.~.~'~!?:*. ~.~ .~.~...~ .. ~.~ ~.~ .t**~.L~....~.~:~.'..~.~2.~.~ ............ ~. ...................................................
ot premises Iocoted ot **~.D***..~.:~.~L~..***;~£c~:~ .......... ~.~ ...................................................................
..................................................... C~?;?.,.!~. ~.~.....) :***~*** ........................................................................
pursuont to opplicotion doted .................................. ~ ................. , 19.,.-***, ond opproved by the
Building Inspector.
Fee $..t.,~ Z .C.)..0. ...........
Building Inspecto1